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Fecal microbiota transplantation broadening its application beyond intestinal disorders

Bob

Senior Member
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16,455
Location
England (south coast)
This open access review was published in Jan 2015, highlighted by Erica Verrillo on Twitter: https://twitter.com/EricaVerrillo

It mentions CFS.

Fecal microbiota transplantation broadening its application beyond intestinal disorders
Meng-Que Xu, Hai-Long Cao, Wei-Qiang Wang, Shan Wang, Xiao-Cang Cao, Fang Yan, and Bang-Mao Wang.
Published online 2015 Jan 7.
World J Gastroenterol. 21: 102–111.
doi: 10.3748/wjg.v21.i1.102
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284325/

Abstract
Intestinal dysbiosis is now known to be a complication in a myriad of diseases. Fecal microbiota transplantation (FMT), as a microbiota-target therapy, is arguably very effective for curing Clostridium difficile infection and has good outcomes in other intestinal diseases. New insights have raised an interest in FMT for the management of extra-intestinal disorders associated with gut microbiota. This review shows that it is an exciting time in the burgeoning science of FMT application in previously unexpected areas, including metabolic diseases, neuropsychiatric disorders, autoimmune diseases, allergic disorders, and tumors. A randomized controlled trial was conducted on FMT in metabolic syndrome by infusing microbiota from lean donors or from self-collected feces, with the resultant findings showing that the lean donor feces group displayed increased insulin sensitivity, along with increased levels of butyrate-producing intestinal microbiota. Case reports of FMT have also shown favorable outcomes in Parkinson’s disease, multiple sclerosis, myoclonus dystonia, chronic fatigue syndrome, and idiopathic thrombocytopenic purpura. FMT is a promising approach in the manipulation of the intestinal microbiota and has potential applications in a variety of extra-intestinal conditions associated with intestinal dysbiosis.
 
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Sasha

Fine, thank you
Messages
17,863
Location
UK
I wonder if the 'case reports' refer to the Borody study. It wasn't very well reported and it's a bit difficult to know what to make of it but the claimed success rate was very high.

I'd love to see a proof-of-concept trial, if anyone was brave enough to risk it!
 

mfairma

Senior Member
Messages
205
I tried fecal transplants two years ago and again one year ago. I'll try to get a response together with an explanation of the effects, as it takes some explanation. In short, the transplants totally corrected and restored significant, lasting GI issues, but made me substantially more ill physically and substantially more cognitively impaired, such that I struggled even to figure out how to write a check to pay a monthly credit card bill, which I do every month. The cognitive and physical function improved over time, but I have not regained what I lost. We believe, however, that this effect may be due to issues regarding the donor used and are looking into alternative donors for a second trial.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
We believe, however, that this effect may be due to issues regarding the donor used and are looking into alternative donors for a second trial.
Thank you for sharing your experience, mfairma.

I would strongly suggest avoiding doing a further fecal transplant if it has harmed you previously. In my experience, if something makes my ME worse then I should stay away from it and not experiment with it further.

Some ME patients may be especially sensitive to gut microorganisms because of our dysregulated immune systems and/or leaky gut etc. It may even be the case that our immune systems (and our symptoms) are antagonized and inflamed by some types of gut bacteria.

I've had a disastrous health experience with over-the-counter probiotics. They caused/precipitated a major negative direction in my ME, with a range new symptoms.
 
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Sasha

Fine, thank you
Messages
17,863
Location
UK
People on the resistant starch thread are reporting that tiny doses or prebiotics and/or probiotics are causing them problems. This is such a contrast with what the Borody FMT study seems to show.
 

mfairma

Senior Member
Messages
205
I appreciate your concern, Bob, and am aware of the risks and that I could get sicker still, but I wouldn't consider it if I didn't have good reasons to believe a second trial made sense and good reason to be willing to take the risks. I'll explain, but it will take me a couple days to get something together.
 

Sidereal

Senior Member
Messages
4,856
I wonder if the 'case reports' refer to the Borody study. It wasn't very well reported and it's a bit difficult to know what to make of it but the claimed success rate was very high.

That's a nice way of putting it.
 

adreno

PR activist
Messages
4,841
I have considered FMT in the past, however at this point I dare not, and not just because of the pathogen risk. I certainly don't want a huge load of lactate-producing species dumped in my GI tract.
 

Sidereal

Senior Member
Messages
4,856
I think FMT has the potential to make ME much much worse due to the breached intestinal barrier. Also, if FMT can alleviate Parkinson's or MS it stands to reason your donor could be a carrier so you could introduce those bacterial pathogens into your gut that cause those diseases in the first place.

There are just so many unknown variables at this point. I consider this treatment to be way too risky at present.
 

Sidereal

Senior Member
Messages
4,856
Sorry, I don't understand what you mean. I don't see how the two ideas are connected. What am I missing?

It is my personal belief that bacterial dysbiosis plays a large part in the pathogenesis of all kinds of currently mysterious neurodegenerative and immune diseases. We have no idea what causes most diseases so there's no way to screen for those pathogens if they are indeed present. How would you know your donor isn't a carrier for something he/she is going to develop 10 years later?

Acta Neuropathol. 2014 Feb;127(2):235-41. doi: 10.1007/s00401-013-1214-6. Epub 2013 Nov 17.
Accumulation of α-synuclein in the bowel of patients in the pre-clinical phase of Parkinson's disease.
Hilton D1, Stephens M, Kirk L, Edwards P, Potter R, Zajicek J, Broughton E, Hagan H, Carroll C.
Author information

Abstract
Parkinson's disease primarily affects the central nervous system, but autopsy and small patient studies have revealed autonomic nervous system pathology in most cases. We looked for α-synuclein pathology in routinely acquired biopsies from patients and matched controls. Immunocytochemistry was performed and assessed blind to the clinical diagnoses. One hundred and seventeen gastrointestinal tissue samples from 62 patients, and 161 samples from 161 controls, were examined. Twelve biopsies from seven patients showed accumulation of α-synuclein within mucosal and submucosal nerve fibres, and ganglia, which was more extensive with an antibody to phosphorylated, than with an antibody to non-phosphorylated, α-synuclein. These included gastric, duodenal and colonic biopsies, and were taken up to 8 years prior to the onset of motor symptoms. All patients with positive biopsies had early autonomic symptoms and all controls were negative. This large scale study demonstrates that accumulation of α-synuclein in the gastrointestinal tract is a highly specific finding that could be used to confirm a clinical diagnosis of Parkinson's disease. We have shown that α-synuclein accumulation occurs prior to the onset of motor symptoms in the upper, as well as the lower gastrointestinal tract, remains present in serial biopsies until the onset of motor symptoms and is predominantly composed of phosphorylated α-synuclein. Accumulation of α-synuclein in the bowel therefore offers an accessible biomarker which allows further study of the early stages of the disease and could be of value in the assessment of disease modifying treatments.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
It is my personal belief that bacterial dysbiosis plays a large part in the pathogenesis of all kinds of currently mysterious neurodegenerative and immune diseases. We have no idea what causes most diseases so there's no way to screen for those pathogens if they are indeed present. How would you know your donor isn't a carrier for something he/she is going to develop 10 years later?

I see what you mean - thanks!
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Which species if you remember @Bob?
The supplement included a number of species, but I think my reaction may have been due to lactobacillus salivarius. It's a strange probiotic that acts a bit like an antibiotic, in that it kills quite a lot of other gut bacteria, which is why it's sometime used for diarrhoea. And since my nasty reation to that, I can't tolerate any off-the-shelf probiotics any more.